3歳児健診における新しい視力検査ソフトの評価

Evaluation of a novel visual acuity testing software for children at municipal three-year-old checkup center

要約　目的：幼児用に開発された視力検査ソフトウェアを用い，幼児施設と3歳児健診会場での3歳児の視力検査結果を比較し，本ソフトの有用性を検討する。

対象と方法：対象は，高知県南国市の3つの幼児施設に在籍する67人と，高知市3歳児健診を受診した34人（合計101人）の3歳児。ソフトには，子どもたちの興味を惹くビデオゲームのようなアニメーションと音響効果，そして，国際基準に則ったランドルト環計算式がプログラムされており，目標視力と検査距離に応じたランドルト環が表示される。被験児には，検査前にカードを用いた練習時間が設けられた。同一の眼科医により，1mの距離で，0.1，0.4，0.8の視力測定が行われた。

結果：健診会場では，検査終了ができなかった3歳児と，各眼0.8以上の視力が得られなかった3歳児の数が，幼児施設と比較して有意に多かった（Pearsonのχ²検定，p＜0.01）。同時に施行されたSpot Vision Screener（Welch Allyn社）による屈折異常検査では，2つのグループに有意差はなかった。

結論：幼児施設で有用であった本ソフトは，3歳児健診では，諸事情によりその有用性は限定的であった。今後，筆者らが開発したソフトウェアのように，操作が簡単かつ正確で，効率的な視力検査ツールが普及し，幼児施設に在籍する幼児に定期的な視力検査が施行されることが望まれる。

Abstract　Purpose：To evaluate the benefit of a newly developed visual acuity testing software for young children, we analyzed the results obtained from two different 3-year-old groups, one at nursery schools and another at a municipal 3-year-old health checkup center.

Subjects and Methods：The subjects were 101 3-year-olds, including 67 children in three nursery schools in Nankoku City, Kochi, and 34 children who visited the 3-year-old health checkup center in Kochi City. The software was designed, resembling video games, to attract children's attention with animated and sound effects, as well as a Landolt ring that can be adjusted by a formula adhering to international standards, depending on the target visual acuity level and test distance.

Results：The number of children who were not able to complete the examination or children who did not achieve 0.8 or higher visual acuity in either eye was significantly greater at the health checkup center than at nursery schools（Pearson's chi-square test, p＜0.01）. The number of children with refractive errors examined simultaneously by the Spot Vision Screener（Welch Allyn, USA） showed no significant difference between the two groups.

Conclusion：Despite its usefulness in nursery schools, the software's evaluation in 3-year-old child health checkups was restricted due to various reasons. It is anticipated that the visual acuity testing tool, which is easy to manage, accurate, and efficient like our new software, will become more widely used and that children at nursery schools will have annual visual acuity assessments.